National Provider Identifier [NPI]: |
1245404896 |
Last Name Of The Provider |
PEARSON |
First Name Of The Provider |
CLAIRE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4201 SAINT ANTOINE ST |
Street Address 2 Of The Provider |
DETROIT RECEIVING HOSPITAL 3R |
City Of The Provider |
DETROIT |
Zip Code Of The Provider |
482012153 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
652 |
Number Of Medicare Beneficiaries |
398 |
Total Submitted Charge Amount |
328224 |
Total Medicare Allowed Amount |
64941.13 |
Total Medicare Payment Amount |
48879.79 |
Total Medicare Standardized Payment Amount |
46982.33 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
652 |
Number Of Medicare Beneficiaries With Medical Services |
398 |
Total Medical Submitted Charge Amount |
328224 |
Total Medical Medicare Allowed Amount |
64941.13 |
Total Medical Medicare Payment Amount |
48879.79 |
Total Medical Medicare Standardized Payment Amount |
46982.33 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
173 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
76 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
215 |
Number Of Male Beneficiaries |
183 |
Number Of Non Hispanic White Beneficiaries |
63 |
Number Of Black or African American Beneficiaries |
316 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
265 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
25 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.5781 |